Employers have no obligation under Arizona law to offer long-term care insurance to their employees. However, if long-term care insurance is among the benefits offered, certain state law requirements limit how the plan may be designed.
A long-term care insurance policy may not limit or exclude coverage by type of illness, treatment, medical condition, or accident, except for the following:
• Preexisting conditions or diseases;
• Mental or nervous disorders (but not Alzheimer's disease);
• Alcoholism and drug addiction;
• Illness, treatment, or medical condition arising out of war or act of war; participation in a felony, riot, or insurrection; service in the armed forces or auxiliary units; suicide, attempted suicide, or an intentional self-inflicted injury; or aviation involving non-fare-paying passengers;
• Treatment provided in a government facility, unless otherwise required by law;
• Services covered by Medicare or other governmental program (except Medicaid);
• Services provided under any state or federal workers' compensation, employer's liability or occupational disease law, or any motor vehicle no-fault law;
• Services provided by a member of the covered person's immediate family and services for which no charge is normally made in the absence of insurance;
• Expenses for services or items available or paid under another long-term care insurance or health insurance policy; or
• In the case of a qualified long-term care insurance policy, expenses for services or items to the extent that the expenses are reimbursable under Title XVIII of the Social Security Act or would be reimbursable but for the application of a deductible or coinsurance amount (AZ Admin. Code R20-6-1004).